Publications of Abdourahmane KABA
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See detailA SINGLE CENTER EXPERIENCE WITH 157 CONTROLED DCD-LIVER TRANSPLANTATIONS
Schielke, Astrid Anita ULiege; Paolucci, Maité ULiege; MEURISSE, Nicolas ULiege et al

in Transplant International (2019, October), 32(S2), 029165

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and ... [more ▼]

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and retransplantation. The authors retrospectively reviewed a single centre experience with controlled DCD-LT in a 15-year period. Patients and Methods: 157 DCD-LT were consecutively performed between 2003 and 2017. All donation and procurement procedures were performed as controlled DCD in the operating theatre. Data are presented as median (ranges). Median donor age was 57 years (16–83). Median DRI was 2.242 (1.322–3.554). Allocation was centre-based. Median recipient MELD score at LT was 15 (6–40). Mean follow-up was 37 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (7–39). Median total ischemia was 313 min (181–586). Patient survivals were 89.8%, 75.5% and 73.1% at 1,3 and 5 years, respectively. Graft survivals were 89%, 73.8% and 69.8% at 1,3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures, that were managed either by endoscopy or hepatico- jejunostomy. Two patients were retransplanted due to intrahepatic ischemic lesions. Conclusion: In this series, DCD LT provides results similar to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy. [less ▲]

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See detailA SINGLE CENTER EXPERIENCE WITH 157 CONTROLED DCD-LIVER TRANSPLANTATIONS
Schielke, Astrid Anita ULiege; Paolucci, Maite; MEURISSE, Nicolas ULiege et al

Conference (2018, November 29)

But du travail: Rapporter une expérience monocentrique de 14 ans de transplantation hépatique (TH) à partir de donneurs en mort circulatoire de type III (DMC III) de Maastricht. Méthodes : 157 TH DMC III ... [more ▼]

But du travail: Rapporter une expérience monocentrique de 14 ans de transplantation hépatique (TH) à partir de donneurs en mort circulatoire de type III (DMC III) de Maastricht. Méthodes : 157 TH DMC III ont été réalisées entre 2003 et 2017. Tous les prélèvements ont été réalisés sur des DMC III dont les soins ont été interrompus en salle d’opération. Aucune perfusion normothermique n’a été utilisée dans cette série. Les données sont présentées en médiane et extrêmes. L’âge des donneurs étaient de 57 ans (16-84). L’âge des receveurs était de 60 ans (21-74), avec un score MELD de 15 (6-40). Le suivi était de 37 mois (6-180). Résultats : L’ischémie chaude totale de prélèvement (de l’arrêt du support respiratoire à la perfusion aortique) était de 19 min (7-39). L’ischémie froide était de 237 min (105-576). Le pic d’ASAT était de 978 U/L (67-21.510). La survie des patients et de greffons étaient de 89,8%, 75,5% and 73,1 % et 89%, 73,8% and 69,8%, à 1, 3 et 5 ans, respectivement. La plupart des complications biliaires ont été des sténoses anastomotiques traitées par voie endoscopique, et 2 patients ont été re-transplantés pour des lésions ischémiques intra-hépatiques diffuses. La majorité des décès étaient dus à des causes néoplasiques (récidive de carcinome hépatocellulaire ou tumeur de novo). Conclusions : cette expérience nous encourage à continuer l’utilisation des DMC III pour la TH. Une ischémie froide courte et une sélection des patients avec des MELD peu élevé peut en partie expliquer ces bons résultats. [less ▲]

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See detailLiver transplantation in Jehovah’s Witnesses: a single center-experience
VANDERMEULEN, Morgan ULiege; MEURISSE, Nicolas ULiege; DAMAS, Pierre ULiege et al

Conference (2018, March 15)

For religious reasons most of the Jehovah's witnesses (JW) refuse infusions of any blood product, including autologous or homologous pre-donated blood, platelets, fresh frozen plasma. However, they may ... [more ▼]

For religious reasons most of the Jehovah's witnesses (JW) refuse infusions of any blood product, including autologous or homologous pre-donated blood, platelets, fresh frozen plasma. However, they may accept solid organ transplantation. The authors report their experience of liver transplantation (LT) in JW over a 20-year period. [less ▲]

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See detailLiver transplantation in Jehovah's witnesses
VANDERMEULEN, Morgan ULiege; MEURISSE, Nicolas ULiege; DAMAS, Pierre ULiege et al

in Acta Gastro-Enterologica Belgica (2018, January), 81(1), 30

Introduction: Liver transplantation (LT) is a major surgical procedure with large dissections and sutures of large vessels in patients with high portal hypertension and low levels of platelets and ... [more ▼]

Introduction: Liver transplantation (LT) is a major surgical procedure with large dissections and sutures of large vessels in patients with high portal hypertension and low levels of platelets and coagulation factors. In consequence, LT often requires large amounts of blood products. For religious reasons, most Jehovah's witnesses (JW) refuse infusions of any blood product, including autologous or homologous pre-donated blood, platelets, fresh frozen plasma, coagulation factor concentrates, or human albumin. However, they may accept solid organ transplantation, including LT. Aim: The authors developed experience in abdominal and oncological surgery in JW and present here their results with LT in JW patients. Methods: Over a 20-year period, 22 LT (16 DBD, 2DCD, and 4 LRLT with JW living donors) were performed in 21 JW patients and were analyzed retrospectively. All patients received perioperative iron supplementation and erythropoietin. Two patients had percutaneous spleen embolization to increase platelet level. Anti-fibrinolytic (aprotinin or tranexamic acid) was administrated during LT and meticulous surgical hemostasis was achieved, helped by argon beam coagulation. Continuous circuit cell salvage and reinfusion whereby scavenged blood was maintained in continuity with the patient's circulation, was used in all patients. Veno-venous bypass was avoided during LT to minimize the coagulation disorders. Results: There were 10 male and 11 female patients whose mean age was 48 years (ranges: 6-70). Indications for LT were HCV with (3) or without (1) HCC, PBC (2), PSC (1), HBV (2), autoimmune hepatitis (1), antitrypsin deficiency (1), sarcoidosis (2), amyloidosis (3), polycystic liver disease (1), alcoholic cirrhosis with HCC (1), cryptogenic (3), hepatic artery thrombosis (1). At transplant, mean pre-operative hematocrit was 41% (ranges: 22-50), mean platelet level was 140x103/mm3 (ranges: 33-355), and mean INR was 1.25 (ranges: 0.84- 2.18).One LRLT recipient died at day 11 from aspergillosis and anemia, and another DBD recipient at day 28 due to complications after hepatic artery thrombosis. One patient finally accepted to be transfused for severe anemia. The mean hospital stay was 31 days (10-137). Kaplan-Maier patient survival was 85%, 72%, 72% at 5, 10 and 15 years, respectively Conclusions: According to the authors' experience, LT may be successful in selected and prepared JW patients who should not be a priori excluded from this life saving procedure. The indications for LT in JW were quite different from the common indications for LT, with a low rate of alcoholic cirrhosis. The experience with this particular group of patients helped the team to reduce transfusion needs in the non-JW patients. [less ▲]

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See detailSurgical factors and not donor type per se are risk factors for acute kidney injury after liver transplantation
MEURISSE, Nicolas ULiege; Smet, Heloise ULiege; LEDOUX, Didier ULiege et al

in Transplant International (2017, September), 30(S2), 106-107298

Background: Because Liver Transplantation (LT) using DCD has been shown to be risk factor for Acute Kidney Injury (AKI), we reviewed results at our center. Patients and Methods: AKI was defined as ... [more ▼]

Background: Because Liver Transplantation (LT) using DCD has been shown to be risk factor for Acute Kidney Injury (AKI), we reviewed results at our center. Patients and Methods: AKI was defined as decrease >50% eGFR (CKD- EPI) within 48 h postreperfusion (RIFLE). 106 first LT-only [63 DBD (59%) & 43 DCD (41%)] without pre-existing renal dysfunction (eGFR>60 ml/min/1,73 m2, no renal replacement therapy) were performed from 2012 to 2016. Incidence/ risk factors for AKI were assessed. Data: mean (IQR). Results: Incidence of AKI was 33% (35/106). AKI-patients were more hospitalized before LT [9/16 (56%) vs 26/89 (29%), p < 0.01], with higher labMELD [16 (10–23) vs 12 (8–16), p = 0.01]. Donor type [11/43 DCD (25%) vs 24/63 DBD (39%), p = 0.16], donor hepatectomy time [38 min (26–50) vs 35 (25–42), p = 0.37], cold ischemic time [6 h (4.1–7.6) vs 5.1 (3.4–6.4), p = 0.21], time for anastomosis [44 min (35–49) vs 42 (38–48), p = 0.53], postreperfusion syndrome [19/46 (42%) vs 27/46 (58%), p = 0.07] were similar between AKI & non-AKI groups. AKI was more frequent if lungs were procured first in the donor [23/48 (48%) vs 11/56 (19%), p < 0.01]. Recipient surgery was longer in the AKI group [5.2 h (3.9–6.3) vs 4.3 (3.4–4.8), p < 0.01]. AKI was more frequent if platelets were transfused during LT [19/42 (56%) vs 15/59 (44%), p = 0.03]. Blood volume administrated from the cellsaver was larger in the AKI-patients [834 ml (300–750) vs 408 (0–550), p = 0.03]. AKI-patients have a higher peak AST [1235 U/L (310–1858) vs 812 (429–978), p = 0.04]. Haemoglobin [8.8 g/dl (7.4–9.9) vs 10 (8.5–11.7)] & platelets [69x103 (50 9 103–87 9 103) vs 89 9 103 (50 9 103–118 9 103)] at day 1 postreperfusion were significantly lower if AKI occurred. After multivariable analysis, thoracic procurement before liver [OR 5.75 (1.76–18.77), p = 0.004] & recipient surgery duration [OR 1.64 (1.15–2.32), p = 0.006] were only risk factors for AKI. Conclusion: Rapid donor/recipient surgery and not donor type are key factors to prevent AKI-post-LT. [less ▲]

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See detailUne série consécutive de 125 greffes hépatiques à partir de donneurs cadavériques en mort circulatoire
DETRY, Olivier ULiege; MEURISSE, Nicolas ULiege; HANS, Marie-France ULiege et al

in Transplant International (2017, January), 30(Suppl 1), 2481

Introduction: Donation after circulatory death (DCD) has been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and ... [more ▼]

Introduction: Donation after circulatory death (DCD) has been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and retransplantation. The authors retrospectively reviewed a single centre experience with controlled DCD-LT in a 14-year period. Patients and Methods: 125 DCD-LT were consecutively performed between 2003 and 2016. All donation and procurement procedures were performed as controlled DCD in operative rooms. Data are presented as median (ranges). Median donor age was 56 years (16–84). Most grafts were flushed with HTK solution in the first part of experience, and more recently with IGL1. Allocation was centre-based. Median follow-up was 52 (1–164) months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (9–39). Median cold ischemia was 238 min (105–576). Patient survivals were 90.2%, 77.5% and 74.5 % at 1.3 and 5 years, respectively. Graft survivals were 87.7%, 76.3% and 73.2% at 1.3 and 5 years, respectively. Biliary complications included anas- tomotic strictures and extrahepatic main bile duct ischemic obstruction, that were managed either by endoscopy or hepatico-jejunostomy. No PNF was observed in this series and one graft was lost due to ischemic cholangiopathy. Discussion: In this series, DCD LT appears to provide results similar to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy. [less ▲]

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See detailA consecutive series of 100 controlled DCD liver transplantation
DETRY, Olivier ULiege; DE ROOVER, Arnaud ULiege; Ledinh, H et al

in Transplant International (2015, November), 28(S4), 109296

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and ... [more ▼]

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and retransplantation. The authors retrospectively reviewed a single centre experience with controlled DCD-LT in a 12-year period. Patients and Methods: 100 DCD-LT were consecutively performed between 2003 and 2014. All donation and procurement procedures were performed as controlled DCD in operative rooms. Data are presented as median (ranges). Median donor age was 57 years (16–83). Median DRI was 2.16 (1.4–3.4). Most grafts were flushed with HTK solution. Allocation was centre-based. Median recipient MELD score at LT was 15 (7–40). Mean follow-up was 35 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (10–39). Median cold ischemia was 235 min (113–576). Median peak AST was 1132 U/l (282– 21 928). Median peak bilirubin was 28 mg/dL. Patient survivals were 90.7%, 75.5% and 70.7% at 1.3 and 5 years, respectively. Graft survivals were 88.7%, 72.1% and 67.1% at 1.3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures and extrahepatic main bile duct ischemic obstruction, that were managed either by endoscopy or hepatico- jejunostomy. No PNF or graft loss due to ischemic cholangiopathy was observed in this series. Discussion: In this series, DCD LT appears to provide results similar to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy. If symptomatic ischemic cholangiopa- thy is diagnosed, adequate management with endoscopy and surgical hepaticojejunostomy may avoid graft loss and retransplantation. [less ▲]

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See detailLAPAROSCOPIC MAGENSTRASSE AND MILL GASTROPLASTY. FIRST RESULTS OF A PROPECTIVE STUDY
DE ROOVER, Arnaud ULiege; KOHNEN, Laurent ULiege; DE FLINES, Jenny ULiege et al

in Obesity Surgery (2014), 25

Abstract Background TheMagenstrasse and Mill (M&M) procedure is a vertical gastroplasty creating a tubular pouch extending from the cardia to the antrum. This “incomplete sleeve” avoids gastric resection ... [more ▼]

Abstract Background TheMagenstrasse and Mill (M&M) procedure is a vertical gastroplasty creating a tubular pouch extending from the cardia to the antrum. This “incomplete sleeve” avoids gastric resection or band placement. In this paper, we report our experience of the laparoscopic approach of the technique in a selected obese population excluding prominent grazer and/or sweet eaters. Material and Methods One hundred patients (39 males, 61 females) underwent the procedure in a prospective trial.Mean age was 40 years (range 18–68). Mean preoperative BMI was 43.2 kg/m2 (range 35–62). Results The procedure was performed by laparoscopy starting with the creation of a circular opening at the junction of antrum and corpus followed by a vertical stapling to the angle of Hiss. Mean duration of the procedure was 67 (range 40– 122) min. No intraoperative complication occurred. Mean hospital stay (SD) was 2.5 (0.9) days. The single postoperative complication consisted in a mild stenosis that responded to endoscopic dilatation. After a mean follow-up of 15 months (range 9–24), mean percentage of excess body weight loss (SD) was 48(14), 59(18) and 68(24)%, respectively at 3, 6, and 12 months. Quality of life appeared satisfactory with a low incidence of gastroesophageal reflux. The procedure was associated with improvement or resolution of diabetes, arterial hypertension, and dyslipemia at 1 year. Conclusions Our experience demonstrated that the M&M procedure could be performed safely laparoscopically. The satisfactory results on weight loss, obesity-associated mordities, and quality of life will need to be confirmed on longer follow-up. [less ▲]

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See detailIS ULTRA-SHORT COLD ISCHEMIA THE KEY TO ISCHEMIC CHOLANGIOPATHY AVOIDANCE IN DCD- LT?
DETRY, Olivier ULiege; DE ROOVER, Arnaud ULiege; Cheham, Samir et al

Conference (2013, December)

Introduction: Donation after circulatory death (DCD) donors have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of ischemic ... [more ▼]

Introduction: Donation after circulatory death (DCD) donors have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of ischemic cholangiopathy leading to graft loss. The authors retrospectively reviewed a single centre experience with DCD-LT in a 9-year period. Patients and Methods: 70 DCD-LT were performed from 2003 to November 2012. All DCD procedures were performed in operative rooms. Median donor age was 59 years. Most grafts were flushed with HTK solution. Allocation was centre-based. Median total DCD warm ischemia was 19.5 min. Mean follow-up was 36 months. No patient was lost to follow-up. Results: Median MELD score at LT was 15. Median cold ischemia was 235 min. Median peak AST was 1,162 U/L. Median peak bilirubin was 31.2 mg/dL. Patient and graft survivals were 92.8% and 91.3% at one year and 79% and 77.7% at 3 years, respectively. One graft was lost due to hepatic artery thrombosis. No PNF or graft loss due to ischemic cholangiopathy was observed in this series. Causes of death were malignancies in 8 cases. Discussion: In this series, DCD LT appears to provide results equal to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy. [less ▲]

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See detailLaparoscopic liver resection: a single center experience
SZECEL, Delphine ULiege; DE ROOVER, Arnaud ULiege; DELWAIDE, Jean ULiege et al

in Surgical Endoscopy (2013), 27

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See detailFeasibility and accessibility to the laparoscopic procedures in University Hospital of Kinshasa
Nsadi Fwene, Berthier; Veyi Tadulu, D.; Kazadi Mutshim, JM et al

in Surgical Endoscopy (2013), 27

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See detailDonation after cardio-circulatory death liver transplantation.
Le Dinh; DE ROOVER, Arnaud ULiege; KABA, Abdourahmane ULiege et al

in World Journal of Gastroenterology (2012), 18(33), 4491-506

The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ ... [more ▼]

The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT. [less ▲]

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See detailLaparoscopic liver resection: a single center experience
SZECEL, Delphine ULiege; DE ROOVER, Arnaud ULiege; DELWAIDE, Jean ULiege et al

in Acta Chirurgica Belgica (2012, May), 112(3), 631

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See detailDREAM 2012: DEVELOPMENT OF LAPAROSCOPIC SURGERY AT THE UNIVERSITY HOSPITAL OF KINSHASA, DRC
Nsadi Fwene, Berthier ULiege; Veyi, D; Kazadi, J et al

in Acta Chirurgica Belgica (2012, May), 112(3), 8240

Objectives: The technical nature of laparoscopy, and the required specific laparoscopic tools and medical skills, may render this approach difficult in developing countries. We hypothesized that ... [more ▼]

Objectives: The technical nature of laparoscopy, and the required specific laparoscopic tools and medical skills, may render this approach difficult in developing countries. We hypothesized that laparoscopy may be developed in the Cliniques Universitaires de Kinshasa (CUK), and may be cost-effective. The final aim of this program is to bring the benefits of laparoscopy to the DRC population, by allowance of adequate training on the UNIKIN personnel, including anaesthetists, surgeons and nurses, who in the future will have to locally form the DRC medical and nursery students. Methods: With the financial support from Wallonie-Bruxelles International (WBI), a complete CUK team, including a surgeon (2 years training in Belgium), an anaesthetist and nurses, were trained in Belgium and then afterwards in DRC. The laparoscopic equipment was sent to Kinshasa, and three theoretical and practical missions of Belgian teams were organised. Results: Over a 2 year period, 116 laparoscopic procedure were performed, including 32 appendectomies, 41 cholecystectomies, 11 hernia repairs, 9 laparoscopy explorations for peritoneal carcinoma assessment and biopsy, 8 procedures for catheter of dialysis peritoneal, 5 gynecologics procedures, and 10 other miscellaneous procedures. Conclusions: A joined approach, taking into account on one hand the training of the skills locally trained to adapt itself to some difficulties, on the other hand institutions of scientific support and a real program and local will of development of this new procedure are the wages of development, accessibility and durability of such news approach in developing countries. All University and non-University team willing to join such a project are welcome. [less ▲]

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See detailBénéfices démontrés et potentiels de l'administration intraveineuse périopératoire de lidocaïne
Giudice, Véronica; LAUWICK, Séverine ULiege; KABA, Abdourahmane ULiege et al

in Revue Médicale de Liège (2012), 67(2), 81-84

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See detailLaparoscopic liver resection: monocentric university experience
Szecel, D.; ARENAS SANCHEZ, Maria Mara ULiege; DE ROOVER, Arnaud ULiege et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 30

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See detailDREAM 2020: Development of laparoscopic surgery and endoscopy in the university hospital of Kinshasa, DRC
Nsadi, Berthier; Veyi, D.; Kazadi, J. et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 14

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See detailScarless cholecystectomy: laparoscopic surgery by unique umbilical incision
Kohnen, Laurent ULiege; Coimbra Marques, Carla ULiege; De Roover, Arnaud ULiege et al

in Revue Médicale de Liège (2010), 65(10), 543-4

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